If you are a public governmental entity of the state of Missouri, you may be eligible to participate in MPR’s Workers’ Compensation coverage pool. We would welcome the opportunity to provide you with a quote. MPR follows standard underwriting guidelines when considering prospective Members.The following information may be requested:Request for Quote Form – basic group informationMember Entity Information Form – basic group informationState Application, Form 81bWorkers’ Compensation Worksheet (Payroll by Class Code)Employee Concentration WorksheetCurrent Financial Statements (Balance Sheet & Income Statement)Experience Mod Worksheet (for past 3 years)Loss History Report (3/5 years of past losses)SNCC Electrical Exposure Supplemental Application (if applicable)SNCC Watercraft Supplemental Application (if applicable)Mesothelioma Liability Election FormHistorical Payroll (3-5 years)Total annual payrollCopy of your safety programOther criteria as determined by the Board of DirectorsMPR also accepts quote requests from formal Request for Proposals (RFPs) and from brokers and consultants. For additional details regarding the description of our Workers’ Compensation program, view the Workers’ Compensation section of this website.If you are interested in joining Midwest Public Risk’s Workers’ Compensation Pool and receiving a quote, please contact Melanie Matt at (816) 292-7541.
